Program Fosters Dialogue About Creativity and the Brain

May 07, 2012
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"If I needed you, would you come to me? Would you come to me and ease my pain?"

As old-time fiddler Heidi Clare Lambert, artist in residence at UCSF's Memory and Aging Center, sang these lyrics from Townes Van Zandt, her music filled a Parnassus campus conference room — not the typical place to hear such sounds.

"The song is simple, but it's just stunning," Lambert told the doctors, scientists, patients, caregivers and members of the public attending one of her monthly bluegrass workshops, designed to spark discussion about creativity and the brain.

"At first I wasn't really convinced a professional musician had anything to offer these incredibly talented neurologists," Lambert said. "But they've pulled it out of me. They'll ask me questions and I'll think, I'm the one who knows about this.' The whole project has really inspired me."

The Hellman Visiting Artist Program was created by neurologist Dr. Bruce L. Miller, director of the Memory and Aging Center, who plays his harmonica at the workshops and often listens to music when he writes. His 200-song playlist ranges from the Doors and Jefferson Airplane to Pearl Jam and Laura Nyro.

Miller came up with the idea for the residency several years ago. He wanted to create an environment in which the neuroscience community could learn about the artists' craft, and artists in turn, could be enriched by the interaction between UCSF staff and patients.

"This is a city of very creative people," Miller said. "We're really a city of artists and writers and musicians."

Miller also wanted to create a new venue for exploring the way music and other forms of art are generated in, and impact, the brain. He's particularly interested in these questions in terms of therapy and against the backdrop of his research on neurodegenerative diseases.

"Great data exists on how music affects children's development, but less is known about how it works in treating neurological injuries," he said. Separately, he noted that "creativity thrives in the face of a subset of patients with frontotemporal dementia."

His goal for each residency is that a piece of neuroscience research be produced, or something else concrete, such as the grand concert on Thursday, Sept. 20 that will mark the end of Lambert's tenure. He said the next visiting artist will probably be a writer.

Music Makes Us Feel Better

He's keenly aware of the role music plays in his own life. "Music almost brings me into a higher emotional state," Miller said. "It evokes very positive emotions. Music releases chemicals that make us feel better and more creative. It's sort of a cleansing process."

From his office he can see Golden Gate Park, where the free Hardly Strictly Bluegrass Festival takes place every fall, courtesy of philanthropist Warren Hellman, who died in December but made sure it would live on. His annual $15,000 endowment also will guarantee the long-term survival of the three-year-old Hellman Visiting Artist Program at UCSF.

"Warren really knew how to connect people to make something better," said Lambert, a close friend who played with him in October at the UCSF concert that kicked off her year-long tenure.

In a recent workshop, titled "The Logic of Music," she said Van Zandt's "If I Needed You" works because it relies on repetition, is driven by melody, uses straightforward and predictable words, and is very measured. That's how it gets embedded in our brains, Lambert said, as she urged people to sing along. And they did.

"It isn't about your brain. It's about your heart," said Neal Margolis, who'd heard about the workshop two days earlier while visiting UCSF to have some memory lapses checked out. He'd brought his guitar and played with Lambert toward the end of the 90-minute session, which included the Carter Family's "Bear Creek Blues" and Bob Dylan's "Red River Shore."

Lambert, who dances and teaches music, too, lives in Colorado but spends several days in the Bay Area each month. As a result of a referral from UCSF, she also visits Marin Adult Day Care Health in Novato, with a clientele that includes patients from UCSF Medical Center.

"The first time I walked in there it was hard, and shocking in some ways," Lambert said. "A lot of vacant looks. These were very valid lives, and they know they're not what they were. At the end of one hour, those vacant looks were nonexistent. They were engaged, they were sparkling, and some were dancing. I was so moved by how they came to me."

The Mendocino County native witnessed a similar transformation with her longtime friend Chris Hellman (Warren's wife), who now suffers from dementia, as was publicly noted at the farewell concert for her husband in February.

"She'll walk into the room with a down look," Lambert said. "When she hears the music, she'll grow three inches and be smiling and bouncing. It changes her outlook. I suppose I've always known that, but to see how strongly and positively music affects human beings who are suffering has really blown my mind."

Indre Viskontas, a cognitive neurologist at the Memory and Aging Center, said music can seem miraculous because it taps into parts of the brain that developed and evolved before language did, such as the limbic system, which controls emotions and memory, and the human mirror neuron system, which is involved with empathy.

"Music can directly activate these systems, bypassing language and conscious thought," said Viskontas, a classically trained soprano who performs with opera companies and chamber music groups. "What's really wonderful about that, in the context of neurodegenerative diseases, is that some patients are impaired in the verbal domain or have a problem in the consciousness domain. We can tap right into their empathy and emotional systems by using music and help them connect with people."

For patients with Alzheimer's disease, who are caught in the present and don't have a way of keeping their memory systems focused, music from the past can help retrieve memories that would be difficult to access with words or pictures, Viskontas said.

It's highly likely that music preceded language and is an older way of communicating, she added. "It's really ingrained in a deep part of us," she said.

She values the artist-in-residence program because it exposes artists and scientists to each other's worlds in a remarkably symbiotic fashion. Viskontas taught a workshop with Lambert on the intersection between art and science in music, and is still collaborating with the musician's predecessor, Deborah Aschheim, a visual artist who spent two years at the Memory and Aging Center.

"Neurodegenerative disorders are among the most stressful and terrible afflictions because they really do change people," Viskontas said. "It's a place where artists are necessary because they can provide comfort, as well as an outlet for patients and caregivers to express their emotions. They can also show a different perspective of the patients to the doctors who are trying to treat them."

No artist works alone, of course. The Hellman Visiting Artist Program also includes a master clinician, who is Dr. Mary De May, two research scientists and a research fellow.

About UCSF Medical Center
UCSF Medical Center consistently ranks as one of the top 10 hospitals in the United States. Recognized for innovative treatments, advanced technology, collaboration among health care professionals and scientists, and a highly compassionate patient care team, UCSF Medical Center serves as the academic medical center of the University of California, San Francisco. The medical center's nationally preeminent programs include children's health, the brain and nervous system, organ transplantation, women's health and cancer. It operates as a self-supporting enterprise within UCSF and generates its own revenues to cover the operating costs of providing patient care.